CARDIOVASCULAR JOURNAL OF AFRICA • Vol 23, No 6, July 2012
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service and procedure codes, as detailed in the SAMA Doctors’
Guide to Billing. The Department of Health tried to take over
ownership of the RPL without having any experience of the
workings of the coding system. They did not take into account
issues such as the practice costs incurred by doctors (many
practices have huge practice overheads), which was validated by
a practice cost study submission undertaken by the professional
groupings.
Medical schemes also choose their rates of reimbursement on
a basis that they consider to be reasonable, based on the RPL.
It directly affects the amount which privately insured patients
will be able to recoup from their medical schemes for the cost
of health services. New codes are introduced as clinical practice
expands and changes.
The SAPPF with SAMA members have assessed
approximately 600 codes for validation. The hope of the future
is the compilation of a new South African procedure coding
structure which will accurately describe consultations and
procedures. Fees charged by service providers are governed
by the Health Professions Act of 1974. However there is also
the issue of the Competition Act of 1998, which enforces
anti-competitive behaviour by the profession, and this states
that doctors may not conduct unfair, collusive and undesirable
business practices by all charging the same fees.
The organisation has been involved in designing updated
algorithms for PMB conditions. This is the minimum set
of healthcare benefits to which all patients contributing to
medical schemes are entitled. Meetings with the CMS have
been held and evidence-based medicine outcomes shown to
motivate appropriate revisions of the PMB algorithms. As
practicing clinicians, best practice is encouraged and doctors
from the different groups have been involved in updating clinical
guidelines. This includes the lipid and diabetes guidelines, to
name a few. The organisation has been involved in reviewing
the green paper of the National Health Insurance. It also has
joined the International Society of Internal Medicine, which
was originally established in 2004, and is one of three country
members from Africa.
The first annual congress of the FCPSA was held in Cape
Town recently. It was very well received by all attending
colleagues and the calibre of lectures was excellent. Local
speakers from the private sector and academic institutions, as
well as international speakers covered a wide range of subjects
pertinent to practicing physicians. A number of training medical
registrars from different universities were sponsored to attend the
meeting and they were surprised by the extremely high academic
standard.
NAOMI RAPEPORT, MB BCh (Wits), FCP (SA), FACP, FACP
(Hon),
Milpark Hospital, Johannesburg, South Africa
Contact
:
BP
: 6003 Dakar
Tél
: (221) 33 821 55 21
(221) 33 889 38 00 Poste : 3900
Fax
: (221) 33 822 47 46
Mail
:
DAKAR
HEALTHCARE
